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[Abstract] 3749 Clinical determinants of 180-day hospital readmission and mortality in older adults with dementia: a UK-based cohort study
No full textIntroduction Older adults with dementia occupy approximately one quarter of acute hospital beds in England. The risk of hospital readmission within six months of discharge increases with multiple long-term conditions, reduced mobility, and limited interdisciplinary collaboration between primary and secondary care. Subsequently, hospital readmission can increase the risk of mortality in this population. This study aimed to quantify the clinical determinants of readmission and subsequent mortality in older adults with dementia in England.Method A retrospective cohort study was conducted using anonymised data from adults in England aged 65 and over with a recorded diagnosis of dementia. Cases were identified through primary care electronic health records in the Clinical Practice Research Datalink (CPRD) GOLD, between April 1997 and November 2018. Readmissions within 180 days were identified using linked Hospital Episode Statistics. Adjusted logistic regression assessed factors associated with readmission, and Cox proportional hazards regression identified predictors of one-year mortality following readmission.Results The cohort included 24,956 patients from 253 general practices (mean age 81.93 years; 61.6% female). Chronic obstructive pulmonary disease (odds ratio [OR] = 1.26, 95% confidence interval [CI]: 1.15–1.39), diabetes mellitus (OR = 1.21, CI: 1.13–1.30), and chronic kidney disease (OR = 1.14, CI: 1.07–1.22) were strongly associated with readmission. Medication review in primary care within one year prior to admission (OR = 1.08, CI: 1.02–1.14), and primary care consultation within two weeks of discharge (OR = 1.21, CI: 1.15–1.28) were also associated with readmission. One-year mortality following readmission was associated with age (hazard ratio [HR] = 3.20, CI: 2.49–4.11 for ages 90+ versus 65–69), multiple long-term conditions (HR = 1.21, CI: 1.05–1.41 for 4–5 conditions versus none), prescriptions for antipsychotic medication (HR = 1.37, CI: 1.22–1.53), and care home residence (HR = 1.33, CI: 1.10–1.62).Conclusion Knowledge of clinical factors associated with readmission and mortality can inform advanced care planning between health and social care professionals, older adults with dementia and their families.</p
[Discussion] Resisting oppressive state power: insurrectionary joy, liberatory values, engaging with the natural world, and motherhood
No full textDr Andrea Brock is a political ecologist with interests in the relationship between extractivism, infrastructures, corporate power, and state violence, and how these are linked to ecological and social harm. She has conducted research on coal mining, hydraulic fracturing, renewable energy generation, the political ecology of high speed railways in the UK, as well as policing and criminalisation of (ecological) dissent and, most recently, animal liberation and sabotage.
Dr Brock and I met at the 2025 gathering of the European Group for the Study of Deviance and Social Control, in Malmö, Sweden. We attended each other’s presentations – hers on the sabotage of animal killings, the infrastructures of human supremacy and prefiguring anti-speciesist futures, and mine on carceral abolition, the eco-climate crisis and the role of othered knowledge traditions. We found that we both had interests in the criminalisation of climate resistance and the marginalisation of more-than human species, and that we shared an understanding of certain forms of ‘destruction’ as in fact
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structive of alternative futures. I knew I wanted to speak with her further, so our conversation, conducted several months later, touches on overarching themes in her work of resisting oppressive state power, counterinsurgency, insurrectionary joy. We also talk about the importance of centring ideas and action pertaining to alternatives to capitalist extractivism on liberatory values, the ethics of drawing on activist writing for scholarly work, queer ecology, and motherhood.</p
Algorithmic fairness in context: liberty, opportunity, and well-being as ethical anchors
No full textThe pursuit of algorithmic fairness is often framed as a search for universal, mathematically sound principles. Yet in high-stakes domains, e.g., criminal justice, finance, and healthcare, these abstractions collide with distinct ethical, legal, and historical realities. While prior research recognizes fairness as contextual, its systematic operationalization remains unresolved. This paper asks: Do definitions and priorities of fairness systematically differ across these domains, and if so, how? Through comparative analysis of international case studies and fairness literature, we identify unique “fairness signatures” shaped by each domain’s core values, harm profiles, legal mandates, and power dynamics. Our research shows that criminal justice prioritizes procedural safeguards and false positive minimization to uphold due process; finance emphasizes explainability and anti-discrimination compliance to ensure equal opportunity; healthcare balances individualized care with equitable outcomes rooted in bioethics. We show that impossibility theorems reflect not technical limits but irreducible value conflicts. To address this, we propose the Context-Aware Fairness Framework (CAFF), a structured, deliberative methodology for selecting fairness criteria that are ethically grounded, legally viable, and contextually appropriate.</p
Hughlings Jackson’s proposed dietary treatment of epilepsy: John Merson’s cross-over trial of 1875
No full textNo description supplied</p
Essays on technological change and labour market concentration in the United Kingdom
No full textEMBARGOED - expected end date 23.02.2029</p
UniVRse: protocol for a pilot randomised controlled trial of virtual reality cognitive-behaviour therapy for students with social anxiety
No full textBackgroundSocial anxiety is prevalent amongst university students. Cognitive-behaviour therapy (CBT), and graded exposure techniques in particular, is an effective intervention for social anxiety. However, there are a number of barriers preventing the delivery of CBT to students who are socially anxious. Delivering this intervention using virtual reality (VR) can address these implementation issues. We have co-developed with a group of students a VR-CBT intervention (UniVRse) specifically for members of this student group with social anxiety.Methods/designThe present study is a pilot randomised controlled trial conducted in the United Kingdom of the UniVRse intervention compared to a wait-list control group. The aim of the trial is to determine whether a definitive trial is justified by assessing study recruitment, retention, and acceptability, as well as establishing the effect size on the co-primary outcomes for the definitive trial sample size calculation. We aim to recruit 90 socially anxious students—45 in each trial arm. The trial will adopt a mixed-methods approach. We will collect quantitative data at baseline (T0) and post-intervention 6 weeks later (T1). We will invite participants randomised to the intervention arm to complete a qualitative exit interview.DiscussionThe results of this pilot trial will be used to determine whether a definitive trial is justified, and to inform the refinement of the UniVRse programme and trial procedures. In the longer term, the UniVRse intervention has the potential to be an effective and accessible psychological intervention for students with social anxiety.Trial registrationClinicaltrials.gov, NCT05704868. Registered 30th January 2023</p
Do you own your own voice? The challenges of voice cloning and intellectual property
No full textVoice cloning technology, once confined to science fiction, has rapidly become a tangible and sophisticated reality enabled by artificial intelligence and machine learning. This chapter examines the legal implications of unauthorised voice replication through the lens of intellectual property law, with a particular focus on the UK framework. It explores whether current legal instruments, chiefly copyright, performers' rights, and the tort of passing-off, can provide sufficient protection against the misuse of vocal identity. While copyright may protect underlying recordings, it rarely extends to the voice itself, and ownership complexities further hinder enforcement. Performers' rights offer stronger grounds, including moral protections, but remain limited by consent and context. Passing-off may assist celebrities with established goodwill, yet leaves most individuals without recourse. The chapter contrasts this with the more robust publicity rights in the US, as exemplified by landmark cases like Midler and Waits. In light of emerging governmental consultations, it argues for the development of a coherent, dedicated legal framework to address the personal, economic, and ethical risks posed by voice cloning technologies.</p
Non-renewable natural capital and the social cost of carbon in wealth accounting
No full textFossil fuels represent a significant portion of the wealth of resource-rich nations. However, their valuation as non-renewable natural capital in inclusive or comprehensive wealth accounting to indicate sustainability does not embody the external costs of climate change damages. This study consistently incorporates the social cost of carbon (SCC) into the value of depletion of non-renewable natural capital for wealth accounting of resource-rich nations. We derive shadow prices of depletion under different resource allocation mechanisms (RAMs) in the presence of externality costs from emission, allowing for declining extraction and an unburnable natural capital stock constraint. In our application to oil, depletion is valued differently across RAMs, depending on how rent, SCC, and decarbonisation develop in the future. The sustainability implication of the choice of RAM is even more significant in the presence of SCC.</p
Evolving reservoir computers reveal bidirectional coupling between predictive power and emergent dynamics
No full textA long-held tenet of neuroscience posits that intelligence is a collective phenomenon: the brain is more than a mere collection of individual cells because it performs complex predictions that no single neuron can achieve alone. This aligns with the concept of “emergence,” describing systems that exhibit capabilities absent in their constituent parts. While emergence has historically remained a philosophical notion, recent advances provide formal frameworks, grounded in information theory, to quantify it in data. These tools allow us to mathematically capture when a network’s computation generates information that is irreducible to its individual components. Our study leverages these frameworks to determine the extent to which emergent dynamics drive prediction in neural networks. By modeling environmental prediction tasks in bio-inspired networks, we found that performance is tightly coupled with—and often dependent upon—the capacity for emergence. These findings support the hypothesis that emergence plays a functional role in prediction. Crucially, this underscores the utility of modern information-theoretic tools in transforming the view of the brain as a “collective” system from an illustrative idea into a rigorous, analytical approach.</p
Development and user-centered evaluation of smart systems for loneliness monitoring in older adults: mixed methods study
No full textBackground: Loneliness is a critical issue among older adults and constitutes a significant risk factor for a range of physical and mental health conditions. However, current assessment methods primarily rely on self-report questionnaires and clinical evaluations, which are susceptible to recall bias and social desirability bias, highlighting the need for more objective and continuous assessment approaches. Recent studies have reported associations between physiological and behavioral indicators and the experience of loneliness in older adults. While these technologies have demonstrated correlations between physiological and behavioral sensor data and the experience of loneliness, their implementation has been limited. Most systems rely on fixed-location sensors or smartphone apps, with little attention given to the integration of these tools into users’ daily routines. To date, no published studies have applied smart textile technology, which integrates sensing capabilities directly into garments or furniture, as a medium for loneliness detection. This study addresses that gap by exploring the usability, experiential acceptability, and ethical considerations of smart textile-based monitoring systems. Objective: This study aims to assess the perceived usability, acceptability, and emotional resonance of a smart loneliness monitoring system integrating sensing garments, furniture, and a mobile app and identify design implications to guide future improvement and promote sustained engagement among older adults. Methods: Building on earlier conceptual research, a functional prototype system was developed and evaluated through 2 immersive in-person workshops with older adults (N=10). A mixed methods approach was applied, combining structured questionnaires, sensory ethnographic observations, focus group discussions, and experience-based co-design. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically to explore user perceptions related to system usability, emotional response, lifestyle compatibility, and ethical considerations. Results: Quantitative data indicated high user satisfaction in dimensions such as comfort, ease of use, and feedback clarity. However, trust in long-term monitoring and willingness to use the system regularly varied. Thematic analysis revealed 4 main areas influencing acceptance, including wearability, usability, and daily integration; trust, privacy, and data control; perceptions of loneliness and the limits of detection; and adoption, applicability, and ethical futures. Participants emphasized the need for discretion, personalization, and human oversight in system feedback and data-sharing mechanisms. Conclusions: The resulting prototype was positively received, demonstrating the potential of smart systems for passive and personalized loneliness monitoring among older adults. However, adoption is influenced by perceptions of autonomy, emotional sensitivity, and contextual integration. Future development should focus on modularity, transparency, and integration within care infrastructures to ensure ethical and sustainable deployment.</p